ISRHML
The International Society for Research in Human Milk and Lactation
ISRHML
The International Society for Research in Human Milk and Lactation

Nominations for Position: Councilor (2 positions available)

Jimi Francis (USA)

University of Texas at San Antonio

I have been a member of ISRHML for over ten years. I have the skill set and historical experience needed to accomplish the tasks outlined in the Bylaws for the position of Counselor, and I would appreciate this opportunity to give back to the Society I have enjoyed participating in so much over the years. I have worked in many areas of human milk and lactation, doing bench work on human milk and clinical work with new families. I have trained breastfeeding peer counselors, home health workers, nurses, midwives, and physicians from fundamental information on human milk composition all the way through advanced lactation management. I have taught lactation physiology at three medical schools and continue to have active clinical practice. I have mentored several students through their training and exams to become certified IBCLC. Aside from my background in lactation, I am a Registered Dietitian and Licensed in the State of Texas as a Dietitian. My nutritional focus is on maternal/infant health. I continue to learn from the families and students I have the pleasure to interact with and want to share the knowledge I have gained over the years with others to understand human milk lactation better.

Dr. Jimi Francis became an Internationally Board-certified Lactation Consultant (IBCLC) in 1993 and began a Master of Science degree in nutrition with a focus on infant nutrition at the University of Nevada in Reno around that same time. She then went on to complete a Doctoral degree in Nutrition at the University of California in Davis with major professor Dr. K. G. Dewey and a focus on maternal/infant nutrition with graduate minors in Medical Microbiology and Human Physiology. Jimi completed her Dietetics Internship through the University of Iowa with a Fellowship at the 96th Medical Group at Eglin Air Force Base. Currently, Dr. Francis is an Assistant Professor at the University of Texas at San Antonio in the Department of Kinesiology in the College for Health, Community, and Policy teaching nutrition and dietetics graduate and undergraduate courses. She continues to assist new families through her private practice as a Lactation Consultant/Nutritionist and serves as a Trainer for the Texas Department of State Health Services Advanced Lactation Management Training for health care providers. 

Alexandra George (AUS)

Baker Heart and Diabetes Institute

Since joining in 2018, I have been an active member of ISRHML and have enjoyed contributing to, and participating in, all areas of the Society. ISHRML has been critical to my development as an early career scientist and so in standing for Council I will be proud to contribute, and add, to all that the Society already does. I have participated on the ISRHML Membership task group and subsequently co-chaired the first Pacific Webinar series, bringing together researchers from across the Pacific to connect and network and showcase the research going down here. I have attended and presented at every ISRHML Conference since Japan in 2018, and I actively participate in webinars and other online events. These have allowed me to develop a large international ISRHML network, with whom I collaborate with and keep in touch with frequently. I also bring a strong record of society and committee service, including chairing the Baker Heart and Diabetes Institute Early-Mid Career Research (EMCR) Committee (2022-present), I am the lead EMCR for the Australia New Zealand Metabolomics Society (2023-present), I have been the Secretary and am now the Treasurer for the DOHaD ANZ Society (2022-present), and I have been on diversity, webinar, and conference committees for all of these societies and Baker Institute over the past six years. I am an advocate for increasing awareness of human milk and lactation research everywhere I go, especially in promoting human milk ‘omics with many non-human milk/lactation researchers. The skills and knowledge I have developed in these works will allow me to make positive contributions to ISRHML, particularly in my passions in driving early career scientist engagement and collaboration, human milk/lactation research advocacy, Pacific engagement, and diversity and equity, and to continue to support the society’s mission. Thank you for your consideration.

Alexandra is a Research Officer at the Baker Heart and Diabetes Institute, in Melbourne Australia, where she leads the human milk and early life research in the Metabolomics Laboratory. Her research focuses on the complex human milk lipidome, utilising state-of-the-art lipidomics liquid-chromatography-mass spectrometry, and aims to gain understanding of bioactive human milk lipids that protect the infant against obesity, diabetes, and cardiovascular disease. Alexandra has received numerous research awards to support her work, including ISRHML-FLRF travel and bridge funds, philanthropic funding, institutional funding, and medical research foundation funding, as well as a multitude of presentation invitations and awards for international conferences and societies. She has received attention nationally and internationally, and is especially proud of her capacity to garner interest in her work from many different non-human milk/lactation researchers.

Kirsi Järvinen-Seppo (USA)

University of Rochester School of Medicine

I have been a member of ISRHML since 2000 and filled a one-year Councilor position in 2018-19. I served as the Member and the Chair of the Scientific Review Board of ISRHML in 2018-22. As an expert on development of infant immunity and human milk immunologic composition, I have served on many advisory and expert panels relating to breast milk and formula composition including the USDA-HHS Dietary Guidance Development Project for Infants and Toddlers from Birth to 24 Months and Pregnant Women, Integration and Application Working Group (WG4) for “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” project by NICHD, and NIH-FDA sponsored “Use of Bioactive Ingredients in Infant Formula” workshop. As a Councilor, my goal would be to assist the society in strategic planning to promote high-quality research in breastfeeding and human milk composition and to promote training of the next generation of investigators in the field. Our society has a unique opportunity to advance the public understanding of the health benefits afforded by human lactation backed up by the scientific evidence.

I am a Professor in Pediatrics, Medicine and Microbiology/Immunology, and the Chief of Pediatric Allergy and Immunology at the University of Rochester, Golisano Children’s Hospital, NY. I also hold the Founders’ Distinguished Endowed Chair in Pediatric Allergy. I received my M.D. followed by a Ph.D. in Human Milk Immunology at the University of Helsinki, Finland in 2000. After defending my thesis, I completed a Postdoctoral Fellowship at the Jaffe Food Allergy Institute in the Icahn School of Medicine at Mount Sinai, New York, followed by a residency in pediatrics and a fellowship in allergy and immunology at the Mount Sinai Hospital, where I hold an Adjunct Faculty appointment. I am the Director of the Center for Food Allergy that is the FARE Clinical Network Center of Excellence, sponsored by the Food Allergy Research and Education. This is a multidisciplinary program that provides comprehensive care to families with food allergies including specialists in allergy, gastroenterology, dermatology, and counseling for dietary and psychologic aspects. I am a practicing pediatric allergist with clinical interests focused on various types of food allergy and atopic dermatitis.

 

My NIH-funded translational research program is focused on developmental aspects of the infant systemic and mucosal immune system relating to mechanisms behind development of food allergy, atopic dermatitis and the whole atopic march. I am particularly interested in the role of maternal and infant environmental factors and human milk composition (IgA, soluble mediators, oligosaccharides, microbiome, metabolites) in shaping the early infant immune system and use human cohorts and laboratory bench research approaches to answer the mechanistic questions. I am also interested in antibody-mediated protection against respiratory and diarrheal diseases provided by human milk in infants, funded through the Bill and Melinda Gates Foundation. Utilizing human cohorts, our particular focus is the role of breast milk components and early environmental exposures in the development of microbiome and infant immune system. I have published ~100 peer reviewed manuscripts, reviews and book chapters and am the Associate Editor for Frontiers in Allergy.

 

I have been a member of ISRHML since 2000 and filled a one-year Councilor position in 2018-19. I served as the Member and the Chair of the Scientific Review Board of ISRHML in 2018-22. As an expert on development of infant immunity and human milk immunologic composition, I have served on many advisory and expert panels relating to breast milk and formula composition including the USDA-HHS Dietary Guidance Development Project for Infants and Toddlers from Birth to 24 Months and Pregnant Women, Integration and Application Working Group (WG4) for “Breastmilk Ecology: Genesis of Infant Nutrition (BEGIN)” project by NICHD, and NIH-FDA sponsored “Use of Bioactive Ingredients in Infant Formula” workshop. As a Councilor, my goal would be to assist the society in strategic planning to promote high-quality research in breastfeeding and human milk composition and to promote training of the next generation of investigators in the field. Our society has a unique opportunity to advance the public understanding of the health benefits afforded by human lactation backed up by the scientific evidence. 

Tricia Johnson (USA)

Professor, Department of Health Systems Management
Rush University, USA

As a long-term ISRHML member with a primary research focus in the economics of breastmilk provision in the newborn intensive care unit (NICU) population, I am deeply interested in serving on the ISRHML Executive Committee. I see many opportunities within ISRHML to integrate economic science with the already strong basic and translational research collaborations that exist within the society. I currently chair the Nutrition Economics Special Interest Group within the International Society of Pharmacoeconomics and Outcomes Research, with the goal of convening researchers at the intersection of nutrition and economic outcomes. I would bring this same passion and human milk-specific economic expertise to the ISRHML Executive Committee. In my position as a Professor of Economics in the Department of Health Systems Management at Rush University Medical Center, I have served as a leader in organizational efforts to advance diversity and inclusion in research and career development, first as the executive director of a public-private partnership to strengthen and diversify the health care workforce, and now as the co-chairperson of the research committee of the Rush BMO Institute for Health Equity (RBIHE; funded by BMO Financial Group), where I have launched and now oversee an early and mid-career health equity scholars program. I would work with the Executive Committee to continue building inclusive, collaborative, and diverse global opportunities to exchange ideas, foster professional development and advance science, including broad dissemination that can inform international economic policies related to human milk, lactation and breastfeeding. Additionally, I would leverage my international experience in working to strengthen the healthcare infrastructures in low and middle income countries to introduce economic methodologies and approaches that inform research strategies in these areas. I am one of the few human milk economists in the world with interests that intersect breastmilk provision, economic consequences and policy for premature infants in the NICU. I have authored over 90 refereed papers, including 17 on these topics, and currently serve as multi-principal investigator (with Aloka Patel, MD) on two US federally-funded studies that test the effectiveness and cost-effectiveness of an intervention aimed at overcoming economic barriers to breastmilk provision for mothers of very preterm infants in the NICU. My current research interests are expanding in two areas: 1) to understand the role of paid and unpaid work in decisions about breastmilk provision for mothers of very preterm infants and 2) to advance the science of secretory activation by richly exploring the economic implications of its translational implications. All of these studies incorporate multiple opportunities for early careerist scholars and trainees, especially those of underrepresented backgrounds, to participate in research and develop necessary skills to become independent investigators. I have benefited from outstanding mentorship throughout my career and am enthusiastic about supporting strategies for mentorship within human milk and lactation science globally and within ISRHML in particular. As one example, I would be interested in developing health economic research opportunities and collaborations within the Trainee Interest Group. I have been a member of ISRHML since 2012 and have attended every meeting since joining the Society. I am passionate about ISRHML’s mission and its focus on interdisciplinary research and would dedicate the time and effort required to be a productive member of the Executive Committee.

INSTITUTION AND LOCATION

DEGREE

Completion Date

FIELD OF STUDY

Coe College; Cedar Rapids, IA

BA

05/1993

Economics and Business Administration

The University of Iowa; Iowa City, IA

MA

05/1995

Hospital and Health Administration

Arizona State University,  W. P. Carey College of Business; Tempe, AZ

 MS

05/2001

Economics

Arizona State University,  W. P. Carey College of Business; Tempe, AZ

 PhD

12/2002

Economics

 

 

Recent grant funding related to my work with the research team includes:

 

R01 HD107348-01A1

Johnson & Patel (Multi PI)

09/15/2022 – 05/31/2027

Early Childhood Neurodevelopmental, Economic and Nutritional Outcomes among Former Very Low Birth Weight Infants from the Reducing Disparity in Mother’s Own Milk (ReDiMOM) Trial

Eunice Kennedy Shriver National Institute of Child Health and Human Development

 

R01 MD013969

Patel & Johnson (Multi PI)

04/18/2020 – 12/31/2024

Reducing Disparity in Receipt of Mother’s Own Milk in Very Low Birth Weight Infants, An Economic Intervention to Improve Adherence to Sustained Maternal Breast Pump Use

National Institute of Minority Health and Health Disparities

 

Additionally, I have been co-investigator on multiple externally funded projects to lead the economic evaluation of interventions to improve health in vulnerable populations. Recently completed studies include:

 

R01 NR017635

Buchholz (PI)

03/15/2018 – 01/31/2022

Testing Adaptive Interventions to Improve Physical Activity for Sedentary Women

National Institute of Nursing Research

 

R01 DK111358-01

Appelhans (PI)                                                                                                                                                           

02/01/2017 – 01/31/2022

Value and Mechanisms of Home Visitation in Obesity Interventions for Low-Income Children

National Institute of Diabetes and Digestive and Kidney Diseases

 

R01 HD086211-01A1

Ailey (PI)                                                                                                                                                                    

09/01/2016 – 08/31/2021

Steps to Effective Problem Solving

National Institute of Nursing Research                                 

 

Citations include:

 

  1. Johnson TJ, Patra K, Greene MM, Hamilton M, Dabrowski E, Meier PP, Patel AL. NICU human milk dose and health care use after NICU discharge in very low birth weight infants. J Perinatol. 2019;39:120-8. PMCID: PMC6298834

  2. Johnson TJ, Berenz A, Wicks J, Esquerra-Zwiers A, Sulo KS, Gross ME, Szotek J, Meier P, Patel AL. The Economic Impact of Donor Milk in the Neonatal Intensive Care Unit. J Pediatr. 2020;224:57-65.e4. PMID: 32682581

  3. Johnson TJ, Patel AL, Schoeny ME, Meier PP. Cost savings of mother’s own milk for very low birth weight infants in the neonatal intensive care unit. Pharmacoeconomics – Open. 2022;6(3):451-460. PMID: 35147912

  4. Johnson TJ, Meier PP, Schoeny ME, Bucek A, Janes JE, Kwiek JJ, Zupancic JAF, Keim SA, Patel AL.  Study protocol for Reducing Disparity in Receiving Mother’s Own Milk oin Very Low Birth Weight Infants (ReDiMOM): A randomized trial to improve adherence to sustained maternal breast pump use. BMC Pediatrics. 2022;22(1):27. PMID:  34996401

 

B. Positions and Honors

Professional Experience

2016 – Present

Professor, Department of Health Systems Management, Rush University, Chicago, IL

2013 – 2020

Executive Director, Building Healthy Urban Communities, Rush University Medical Center

2012 – 2020

Associate Chairperson of Education and Research, Department of Health Systems Management, Rush University, Chicago, IL

2011 – 2012

Acting Associate Chairperson, Department of Health Systems Management, Rush University/RUMC, Chicago, IL

2009 – 2016 

Associate Professor, Department of Health Systems Management, Rush University, Chicago, IL 

2006 – Present

Director, Rush Center for Health Management & Policy Research, RUMC, Chicago, IL

2002 – 2009

Assistant Professor, Department of Health Systems Management, Rush University, Chicago, IL 

2001

Instructor, School of Health Administration and Policy, Arizona State University, Tempe AZ

2001

Summer Research Associate, RAND Institute for Civil Justice, Santa Monica, CA

1998 – 2002

Research Associate, School of Health Administration and Policy, Arizona State University, Tempe AZ

1997 – 2000

Management Engineer, Mayo Clinic Scottsdale, Scottsdale AZ

1995 – 1997

Administrative Trainee, Mayo Foundation, Rochester MN

 

Honors and Professional Activities

2022 – Present

2021

 

Chairperson, International Society of Pharmaceutical and Outcomes Research Nutrition Economics Special Interest Group

Incoming Chairperson, International Society of Pharmaceutical and Outcomes Research Nutrition Economics Special Interest Group

2012 – Present

Full Member, International Society for Research in Human Milk and Lactation

2009

Fulbright Scholar to Austria, Austrian-American Educational Commission

2003

Program Chair, Workers’ Compensation Research Group Spring Meeting

2003

Fellowship, NIA Summer Institute on Aging Research

2003

Fellowship, RAND MiniMedical School for Social Scientists

2003

Fellowship, RAND Summer Institute on Demography, Epidemiology and Economics of Aging

2001

Emeriti Professor Award for the Outstanding Ph.D. Student in Economics

1999 – 2001

Preparing Future Faculty Scholar

1998 – 2001

University Graduate Scholar

C.  Contribution to Science (Total Publications = 85 original research papers, 5 invited book chapters and 1 book)

  1. Costs and outcomes associated with human milk feeding in very low birth weight infants. My principal contribution to science is translational research focused on the relationship between mother’s own milk with healthcare costs and health outcomes in very low birth weight (VLBW; <1500 g birth weight) infants. VLBW infants are among the most expensive patients in the hospital, and my work has been seminal in quantifying the micro-level costs of care and cost savings associated with reduction in the risks of morbidities in this population. Our published findings have revealed that the cost savings of mother’s own milk reflect potentially different mechanisms for each morbidity. Our team has also published studies on the cost of providing and acquiring mother’s own milk, data which translate readily to day-to-day NICU practice and cost considerations. Most recently, my research has quantified the feeding costs of mother’s own milk and donor human milk from the hospital perspective, capturing both the direct and indirect costs required to support a comprehensive lactation program.

  2. Jegier BJ, Johnson TJ, Engstrom JL, Patel AL, Loera F, Meier P. The institutional cost of acquiring 100 mL of human milk for very low birth weight infants in the neonatal intensive care unit. Journal of Human Lactation. 2013:29(3):390-9. PMCID: PMC4608232

  3. Patel AL, Johnson TJ, Engstrom JL, Fogg LF, Jegier BJ, Bigger HR, Meier PP. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol. 2013;;33(7):514-9. PMID: 23370606

  4. Johnson TJ, Patel AL, Bigger HR, Engstrom JL, Meier PP. Cost savings of human milk as a strategy to reduce the incidence of necrotizing enterocolitis in very low birth weight infants. Neonatology, 2015;107(4):271-6. PMCID:PMC4458214

  5. Patel AL, Johnson TJ, Robin B, Bigger HR, Buchanan A, Christian E, Nandhan V, Shroff A, Schoeny M, Engstrom JL, Meier PP. Influence of own mother’s milk on bronchopulmonary dysplasia and costs. Arch Dis Child Fetal Neonatal Ed, 2017; 102(3):F256-F261. PMCID: PMC5586102

 

  1. Translation of research findings into NICU best clinical practices, with a focus on removing economic barriers to the provision and use of human milk for mothers of VLBW infants. I have collaborated with my clinical research colleagues to prepare state of the science review papers and book chapters that delineate economic barriers to the provision and use of human milk (e.g., acquisition of equipment, supplies and personnel) for VLBW infants and their mothers. This contribution is important because in multiple instances evidence-based best practices have been disseminated, but have not been adopted due to economic constraints. I have worked to address these barriers using cost-effectiveness analyses and other economic analytic approaches and have focused on translating these economic principles into state of the science papers so that clinicians can apply them to day-to-day decision making about cost implications of human milk feedings in the NICU.

  2. Johnson TJ, Patel AL, Bigger HR, Engstrom JL, Meier PP. Economic benefits and costs of human milk feedings: A strategy to reduce prematurity-related morbidities in the neonatal intensive care unit. Advances in Nutrition. 2014;5(2):207-12. PMCID: PMC3951804

  3. Meier PP, Patel AL, Bigger HR, Chen Y, Johnson TJ, Rossman, B, Engstrom JL. Human milk feedings in the neonatal intensive care unit. In R Rajendram, VR Preedy, VB Patel, Eds. In Diet and Nutrition in Critical Care. New York: Springer-Verlag; 2015.

  4. Meier PP, Johnson TJ, Patel AL, Rossman B. Evidence-based methods that promote human milk Feeding in Preterm Infants. Clinics in Perinatology, F. Mimouni, B. Koletzko (Eds). 2017;44(1):1-22. PMCID: PMC5328421

  5. Meier PP, Rossman B, Patel AL, Johnson TJ, Engstrom JL, Hoban R, Patra K, Bigger HR. Human milk in the neonatal intensive care unit. In Breastfeeding and Breastmilk – From Biochemistry to Impact. PE Hartmann & PP Meier (Eds). Thieme: Stuttgart; 2018. 

 

  1. Long-term health and economic consequences of high-dose, long-duration mother’s own milk feedings for VLBW infants. In the last five years, my research has included studies that examine the longer-term benefits of mother’s own milk feedings for VLBW infants. I have co-authored two studies that have examined neurodevelopmental outcomes and healthcare utilization for these infants in the first two years of life. We found that the dose of mother’s own milk during the NICU stay is positively associated with cognitive scores and inversely associated with subsequent hospitalizations, use of pediatric subspecialists and use of specialized therapies. This growing body of research suggests that the economic benefits of mother’s own milk feedings extend into childhood and is a foundation for the proposed study to evaluate whether work mediates the relationship between maternal race/ethnicity and duration of mother’s own milk provision.

  2. Patra K, Hamilton M, Johnson TJ, Greene M, Dabrowski E, Meier PP, Patel AL. NICU human milk dose and 20-month neurodevelopmental outcome in very low birth weight infants. Neonatology. 2017;112:330-6. PMCID: PMC5683911

  3. Johnson TJ, Patra K, Greene MM, Hamilton M, Dabrowski E, Meier PP, Patel AL. NICU human milk dose and health care use after NICU discharge in very low birth weight infants. J Perinatol. 2019;39:120-8. PMCID: PMC6298834

 

  1. Cost and cost-effectiveness of interventions to improve health outcomes. In a fourth line of research, I have collaborated with teams of researchers across fields to evaluate the cost and cost-effectiveness of interventions to improve health outcomes across the lifespan. These studies have made a significant contribution to science by quantifying the program and participant costs relative to the outcomes. Most studies to date have failed to account for participant opportunity costs; however, we found that the opportunity costs represent a large proportion of the total societal costs of these interventions. Because of these findings, my research rigorously evaluates the participate out-of-pocket and time costs as an important component of cost and cost effectiveness analyses.

  2. Gross D, Johnson TJ, Ridge A, Garvey C, Julion W, Brusius Treysman A, Breitenstein S, Fogg L. 2011. Cost-effectiveness of childcare discounts on parent participation in preventive parent training in low-income communities. Journal of Primary Prevention, 32(5-6):283-98. PMCID: PMC3253623

  3. Wilbur J, Buchholz SW, Ingram DM, Braun LT, Johnson TJ, Fogg L, Miller AM, Volgman AS, McDevitt J. Effectiveness, efficiency, duration and costs of recruiting for an African American women’s lifestyle physical activity program. Research in Nursing Health, 2013;36(5):487-99. PMCID: PMC3788077

  4. Johnson TJ, Schoeny M, Fogg L, Wilbur J. The cost of increasing physical activity and maintaining weight for midlife sedentary African American women. Value in Health, 2016:19(1):20-7. PMCID: PMC4724643

  5. Wallace S, Johnson TJ, Hendel E, Chakravarthy V, Leanos L, Ansell DA. The financial impact of a partnership between an academic medical center and a free clinic. Am J Med. 2021;134(11):1389-1395.e4. PMID: 34283952

 

  1. Identifying and quantifying disparities in health outcomes, healthcare service use and costs. Using sophisticated econometric methods, I have evaluated whether disparities exist in healthcare utilization and costs and the downstream implications for health outcomes. Additionally, these analyses have examined whether interventions intended to improve access to care for low income and uninsured individuals have reduced disparities. With many of these analyses being observational studies, I have used a variety of statistical and econometric methodologies, including inverse probability of treatment weighting for causal inference and hierarchical modeling to account for multi-level data.

  2. Patel AL, Schoeny ME, Hoban R, Johnson TJ, Bigger H, Engstrom JL, Fleurant E, Riley B, Meier PP. Mediators of racial and ethnic disparity in mother’s own milk feeding in very low birth weight infants. Pediatr Res. 2019 Apr;85(5):662-670. doi: 10.1038/s41390-019-0290-2. PMCID: PMC6435382

  3. Johnson T, Walton S, Levine S, Fister E, Baron A, O’Mahony S. Racial and ethnic disparity in palliative care and hospice use. Am J Manag Care. 2020;26(2):e36-e40. doi: 10.37765/ajmc.2020.42399. PMID: 32059098

  4. Patel AL, Johnson TJ, Meier PP. Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units. Pediatr Res. 2021;89(2):344-352. doi: 10.1038/s41390-020-01263-y. Epub 2020 Nov 13. Review. PMCID: PMC7662724

  5. Longcoy J, Patwari R, Hasler S, Johnson T, Avery E, Stefanini K, Suzuki S, Ansell D, Lynch E. Racial and ethnic differences in hospital admissions of emergency department COVID-19 patients. Med Care. 2022;60(6):415-422. PMCID: PMC9093229

 

A full list of my publications is available at:

https://www.ncbi.nlm.nih.gov/myncbi/tricia.johnson.1/bibliography/public/

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